Moyamoya disease, also known as spontaneous basilar artery ring occlusion, is a disease characterized by a slow thickening of the intima at the end of the internal carotid artery and the beginning of the anterior and middle cerebral arteries, a gradual narrowing of the arterial lumen to the point of occlusion, and a compensatory dilation of the penetrating arteries at the base of the brain. The shape of the dilated vessels on imaging resembles the curl of smoke in a chimney, which is why the Japanese call it smoke disease. Smoky disease was first discovered by the Japanese. Since 1962, when the first non-Japanese case of smog was reported in Subirana, smog has been reported all over the world, but mainly in the yellow population. The highest incidence is in Japan, followed by South Korea and China and other Southeast Asian regions. There are two peaks in the age of onset: childhood at about 4 years of age and middle age at 30-40 years of age. The ratio of childhood to adult incidence is 5:2. Vascular anastomosis combined with cerebral-dural-superficial temporal artery vascular fusion improves cerebral blood flow immediately, allowing patients to continue to benefit from the de novo spontaneous anastomosis caused by the indirect procedure at a later time. The efficacy of this procedure in improving ischemic symptoms in adult smoker’s disease is definite, and its effectiveness in preventing rehemorrhage in patients with bleeding type remains to be followed up in the long term.